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Clinical Infectious Diseases : An... May 2020Plague is a rare and severe zoonotic illness with limited empiric evidence to support treatment recommendations. We summarize treatment information for all patients with...
BACKGROUND
Plague is a rare and severe zoonotic illness with limited empiric evidence to support treatment recommendations. We summarize treatment information for all patients with plague in the United States (US) as collected under the auspices of public health surveillance.
METHODS
We reviewed use of specific antimicrobials and illness outcome among cases of plague reported from 1942-2018. Antimicrobials were a priori classified into high-efficacy (aminoglycosides, tetracyclines, fluoroquinolones, sulfonamides, and chloramphenicol) and limited-efficacy classes (all others). Logistic regression models were created to describe associations between use of specific antimicrobial classes and illness outcome while controlling for potential confounding factors.
RESULTS
Among 533 total reported plague cases during 1942-2018, 426 (80%) received high-efficacy antimicrobial therapy. Mortality differed significantly among those receiving high-efficacy therapy (9%) and only limited-efficacy therapy (51%). Aminoglycosides and tetracyclines were used more commonly than other classes, and their use was associated with increased odds of survival of plague. Gentamicin use was associated with higher mortality than streptomycin, and aminoglycoside use was linked to higher mortality than for tetracyclines. Fluoroquinolones have been used in treatment of >30% of patients in recent years and limited data suggest clinical effectiveness.
CONCLUSIONS
Most US patients with plague have received effective antimicrobials. Aminoglycosides and tetracyclines substantially improve survival of plague, and fluoroquinolones may be equally as effective, yet lack sufficient data. Early recognition and early treatment with any of these antimicrobial classes remain the most important steps to improving survival of plague.
Topics: Anti-Bacterial Agents; Gentamicins; Humans; Plague; Tetracyclines; United States; Yersinia pestis
PubMed: 32435801
DOI: 10.1093/cid/ciz1227 -
British Medical Journal (Clinical... Jul 1983
Topics: Animals; Humans; Immunization; Insect Control; Mice; Muridae; Plague; Rats; Rodent Control; Siphonaptera
PubMed: 6407702
DOI: No ID Found -
The Western Journal of Medicine Sep 1986
Topics: Humans; Plague
PubMed: 3765623
DOI: No ID Found -
Clinical Microbiology Reviews Apr 2004Increased interest in the pathogenic potential of Yersinia pestis has emerged because of the potential threats from bioterrorism. Pathogenic potential is based on... (Review)
Review
Increased interest in the pathogenic potential of Yersinia pestis has emerged because of the potential threats from bioterrorism. Pathogenic potential is based on genetic factors present in a population of microbes, yet most studies evaluating the role of specific genes in virulence have used a limited number of strains. For Y. pestis this issue is complicated by the fact that most strains available for study in the Americas are clonally derived and thus genetically restricted, emanating from a strain of Y. pestis introduced into the United States in 1902 via marine shipping and subsequent spread of this strain throughout North and South America. In countries from the former Soviet Union (FSU), Mongolia, and China there are large areas of enzootic foci of Y. pestis infection containing genetically diverse strains that have been intensely studied by scientists in these countries. However, the results of these investigations are not generally known outside of these countries. Here we describe the variety of methods used in the FSU to classify Y. pestis strains based on genetic and phenotypic variation and show that there is a high level of diversity in these strains not reflected by ones obtained from sylvatic areas and patients in the Americas.
Topics: Americas; Animals; Asia, Central; Europe, Eastern; Genetic Variation; Humans; Plague; Plague Vaccine; Virulence; Yersinia pestis
PubMed: 15084509
DOI: 10.1128/CMR.17.2.434-464.2004 -
The Lancet. Infectious Diseases May 2019
Topics: Disease Outbreaks; Epidemics; Forecasting; Humans; Madagascar; Plague
PubMed: 30930105
DOI: 10.1016/S1473-3099(18)30794-1 -
BMC Infectious Diseases Mar 2018Although the linkage between climate change and plague transmission has been proposed in previous studies, the dominant approach has been to address the linkage with...
BACKGROUND
Although the linkage between climate change and plague transmission has been proposed in previous studies, the dominant approach has been to address the linkage with traditional statistical methods, while the possible non-linearity, non-stationarity and low frequency domain of the linkage has not been fully considered. We seek to address the above issue by investigating plague transmission in pre-industrial Europe (AD1347-1760) at both continental and country levels.
METHODS
We apply Granger Causality Analysis to identify the casual relationship between climatic variables and plague outbreaks. We then apply Wavelet Analysis to explore the non-linear and non-stationary association between climate change and plague outbreaks.
RESULTS
Our results show that 5-year lagged temperature and aridity index are the significant determinants of plague outbreaks in pre-industrial Europe. At the multi-decadal time scale, there are more frequent plague outbreaks in a cold and arid climate. The synergy of temperature and aridity index, rather than their individual effect, is more imperative in driving plague outbreaks, which is valid at both the continental and country levels.
CONCLUSIONS
Plague outbreaks come after cold and dry spells. The multi-decadal climate variability is imperative in driving the cycles of plague outbreaks in pre-industrial Europe. The lagged and multi-decadal effect of climate change on plague outbreaks may be attributable to the complexity of ecological, social, or climate systems, through which climate exerts its influence on plague dynamics. These findings may contribute to improve our understanding of the epidemiology of plague and other rodent-borne or flea-borne infectious diseases in human history.
Topics: Climate Change; Disease Outbreaks; Europe; Humans; Plague; Temperature; Wavelet Analysis
PubMed: 29554882
DOI: 10.1186/s12879-018-3045-5 -
Proceedings of the National Academy of... Nov 2020Plague continued to afflict Europe for more than five centuries after the Black Death. Yet, by the 17th century, the dynamics of plague had changed, leading to its slow...
Plague continued to afflict Europe for more than five centuries after the Black Death. Yet, by the 17th century, the dynamics of plague had changed, leading to its slow decline in Western Europe over the subsequent 200 y, a period for which only one genome was previously available. Using a multidisciplinary approach, combining genomic and historical data, we assembled genomes from nine individuals covering four Eurasian sites and placed them into an historical context within the established phylogeny. CHE1 (Chechnya, Russia, 18th century) is now the latest Second Plague Pandemic genome and the first non-European sample in the post-Black Death lineage. Its placement in the phylogeny and our synthesis point toward the existence of an extra-European reservoir feeding plague into Western Europe in multiple waves. By considering socioeconomic, ecological, and climatic factors we highlight the importance of a noneurocentric approach for the discussion on Second Plague Pandemic dynamics in Europe.
Topics: DNA, Bacterial; Europe; Genome, Bacterial; History, 18th Century; History, Medieval; Humans; Pandemics; Phylogeny; Plague; Russia; Yersinia pestis
PubMed: 33106412
DOI: 10.1073/pnas.2009677117 -
Emerging Infectious Diseases Dec 2019Since 1970, >50% of patients with plague in the United States had interactions with animals that might have led to infection. Among patients with pneumonic plague,...
Since 1970, >50% of patients with plague in the United States had interactions with animals that might have led to infection. Among patients with pneumonic plague, nearly all had animal exposure. Improved understanding of the varied ways in which animal contact might increase risk for infection could enhance prevention messages.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Animals, Domestic; Child; Child, Preschool; Farmers; Female; History, 20th Century; History, 21st Century; Humans; Infant; Male; Middle Aged; Occupational Exposure; Plague; Public Health Surveillance; United States; Yersinia pestis; Young Adult; Zoonoses
PubMed: 31742515
DOI: 10.3201/eid2512.191081 -
Clinical Microbiology and Infection :... Mar 2014The causative bacterium of plague was described and cultured by Alexandre Yersin in Hong Kong in 1894, after which transmission of bacteria from rodents by flea bites... (Review)
Review
Plague history: Yersin's discovery of the causative bacterium in 1894 enabled, in the subsequent century, scientific progress in understanding the disease and the development of treatments and vaccines.
The causative bacterium of plague was described and cultured by Alexandre Yersin in Hong Kong in 1894, after which transmission of bacteria from rodents by flea bites was discovered by Jean-Paul Simond in 1898. Effective treatment with antiserum was initiated in 1896, but this therapy was supplanted by sulphonamides in the 1930s and by streptomycin starting in 1947. India suffered an estimated 6 million deaths in 1900-1909, and Vietnam, during its war in 1965-1975, accounted for approximately 80% of the world's cases; since then, African countries have dominated, with >90% of the world's cases in the 1990s and early 21st century. Serological diagnosis with fraction 1 antigen to detect anti-plague antibodies was developed in the 1950s. Vaccine development started in 1897 with killed whole bacterial cells, and this was followed by a live attenuated bacterial vaccine, leading to millions of persons receiving injections, but the benefits of these vaccines remain clouded by controversy. Plasmid-mediated virulence was established in 1981, and this was followed by specific DNA methods that have allowed detection of plague genes in skeletal specimens from European graves of the sixth to 17th centuries.
Topics: Animals; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Incidence; Plague; Plague Vaccine; Yersinia pestis
PubMed: 24438235
DOI: 10.1111/1469-0691.12540 -
PLoS Neglected Tropical Diseases Aug 2018The Qinghai-Tibet plateau is a natural plague focus and is the largest such focus in China. In this area, while Marmota himalayana is the primary host, a total of 18...
The Qinghai-Tibet plateau is a natural plague focus and is the largest such focus in China. In this area, while Marmota himalayana is the primary host, a total of 18 human plague outbreaks associated with Tibetan sheep (78 cases with 47 deaths) have been reported on the Qinghai-Tibet plateau since 1956. All of the index infectious cases had an exposure history of slaughtering or skinning diseased or dead Tibetan sheep. In this study, we sequenced and compared 38 strains of Yersinia pestis isolated from different hosts, including humans, Tibetan sheep, and M. himalayana. Phylogenetic relationships were reconstructed based on genome-wide single-nucleotide polymorphisms identified from our isolates and reference strains. The phylogenetic relationships illustrated in our study, together with the finding that the Tibetan sheep plague clearly lagged behind the M. himalayana plague, and a previous study that identified the Tibetan sheep as a plague reservoir with high susceptibility and moderate sensitivity, indicated that the human plague was transmitted from Tibetan sheep, while the Tibetan sheep plague originated from marmots. Tibetan sheep may encounter this infection by contact with dead rodents or through being bitten by fleas originating from M. himalayana during local epizootics.
Topics: Animals; DNA, Bacterial; Disease Reservoirs; Genome, Bacterial; Humans; Marmota; Phylogeny; Plague; Polymorphism, Single Nucleotide; Sheep; Sheep Diseases; Yersinia pestis; Zoonoses
PubMed: 30114220
DOI: 10.1371/journal.pntd.0006635